Elsevier

The Journal of Pediatrics

Volume 165, Issue 6, December 2014, Pages 1109-1115.e3
The Journal of Pediatrics

Original Article
Infant Growth after Preterm Birth and Neurocognitive Abilities in Young Adulthood

https://doi.org/10.1016/j.jpeds.2014.08.028Get rights and content

Objectives

To examine whether faster growth from birth to term (40 postmenstrual weeks) and during the first year thereafter was associated with better neurocognitive abilities in adults born preterm with very low birth weight (VLBW; <1500 g).

Study design

Weight, length, and head circumference data of 103 VLBW participants of the Helsinki Study of Very Low Birth Weight Adults were collected from records. Measures at term and at 12 months of corrected age were interpolated. The participants underwent tests of general neurocognitive ability, executive functioning, attention, and visual memory at mean age of 25.0 years.

Results

Faster growth from birth to term was associated with better general neurocognitive abilities, executive functioning, and visual memory in young adulthood. Effect sizes in SD units ranged from 0.23-0.43 per each SD faster growth in weight, length, or head circumference (95% CI 0.003-0.64; P values <.05). After controlling for neonatal complications, faster growth in head circumference remained more clearly associated with neurocognitive abilities than weight or length did. Growth during the first year after term was not consistently associated with neurocognitive abilities.

Conclusions

Within a VLBW group with high variability in early growth, faster growth from birth to term is associated with better neurocognitive abilities in young adulthood. Neurocognitive outcomes were predicted, in particular, by early postnatal head growth.

Section snippets

Methods

The original cohort of the Helsinki Study of Very Low Birth Weight Adults, described previously24 in detail, consisted of 335 VLBW infants born consecutively between January 1978 and December 1985 and discharged alive (survival rate 70.7%) from the Neonatal Intensive Care Unit of Children's Hospital at Helsinki University Central Hospital in Finland. In 2004-2005, 255 subjects residing in the greater Helsinki area were invited to the first clinical follow-up visit24 and 166 participated. Of

Results

Table II shows body size and growth in infancy. Table III shows neonatal and adult characteristics and neurocognitive test scores. Figure 1 (available at www.jpeds.com) shows the associations between growth in infancy and the individual neurocognitive test scores.

Discussion

In this cohort of 103 unimpaired VLBW individuals with high variability in early growth, faster growth from birth to term was associated with better general neurocognitive abilities, executive functioning, and visual memory in young adulthood. The benefits of rapid growth were relatively large in effect size: for each SD faster growth in weight, PIQ improved by 5.0 IQ points; for each SD faster growth in length, IQ, VIQ, and PIQ improved by 4.5, 3.4, and 5.4 IQ points, respectively; and for

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    This study was part of the Helsinki Study of Very Low Birth Weight Adults, which was funded by the Suomen Akatemia, University of Helsinki, the Finnish Medical Society Duodecim, Finska Läkaresällskapet, the Foundation for Pediatric Research in Finland, the Finnish Special Governmental Subsidy for Health Sciences, the Jalmari and Rauha Ahokas Foundation, the Juho Vainio Foundation, the Emil Aaltonen Foundation, the Novo Nordisk Foundation, the Päivikki and Sakari Sohlberg Foundation, the Signe and Ane Gyllenberg Foundation, the Yrjö Jahnsson Foundation, the Orion-Pharma Foundation, the Sigrid Jusélius Foundation, the Finnish National Graduate School of Clinical Investigation, the Wilhelm and Else Stockmann Foundation, and the Pediatric Graduate School, University of Helsinki. The authors declare no conflicts of interest.

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